As health care reform moves forward in the United States, one common feature of virtually all proposals is to expand coverage for low income populations not through a traditional public insurance model, but rather through a “defined contribution exchange” mechanism. Under this approach, low income individuals would have a choice of a number of options for their insurance coverage. Individuals w...

Background China's Reform and Open up Policy in 1980s has brought rapid economic development to Chinese society. With the deepening of economic reform, the withdrawal of the state in China has had visible and worrisome consequences for health and for the functioning of health services. The new round of healthcare reform after 2009 has made significant achievements on improving fundamental healt...

This paper argues that a desirable health reform plan should accept some features that the Obama and McCain plans have in common, and combine other features from each of the plans. Useful combinations include the presence of both public and private options and a system of credits that are more generous for lower-income households (Obama) and creation of a system of public subsidies that is ince...

The convergence of health reform regulation, consumer demand, market realities and technology developments are driving healthcare organizations to explore new models of care delivery and payment across the delivery spectrum (IOM, 2011, Healthcare.gov). With increasing focus on consumers, there is a growing demand for outcome-based health management (DeNicola, 2012, Sarasohn-Kahn, 2009a). The ex...

741 National Tax Journal Vol. LIV, No. 4 Abstract Market–based health care reform proposals typically rely on 1) consumer choice among competing health plans, 2) premiums paid out–of–pocket for higher priced plans, and 3) a significant out– of–pocket premium–price elasticity of health plan choice. Section 125 of the Internal Revenue Code exempts employee out–of–pocket premiums from personal inc...

Although health insurance exchanges are a growing source of individual coverage, little is known about consumer behavior on these exchanges. While health insurance exchanges are intended to facilitate competition among insurers and make it easier for consumers to access insurance, understanding how consumers choose insurance plans is necessary for the design of these markets. We characterize de...

The vast majority of health plans in the United States require patients to meet cost-sharing requirements that are unrelated to income. Because this is highly inequitable, the authors propose a new system in which cost sharing is explicitly linked to income levels. This proposal differs from earlier proposals to relate cost sharing to income, which relied on the federal income tax system. In th...